PURPOSE: To evaluate clinical efficacy and safety of hyaluronic acid based autologous dermal fibroblasts (Hyalograft 3D) in the treatment of diabetic foot ulcers. METHODS: A total of 28 patients with diabetic ulcers were randomized to either the control group with nonadherent foam dressings(n=14) or the treatment group with autologous tissue-engineered grafts(n=14). Weekly assessment contained vital sign checks, ulcer size measurements, and wound photos. In the 12th week, percentages of complete wound healing and mean healing times were compared. Safety was also monitored by adverse events. RESULTS: Complete wound healing was achieved in 84.6% of the treatment group and 23.1% of the control group(p<0.005). The mean times of closures for the treatment versus control groups were 6.1 weeks and 10.9 weeks, respectively. No adverse events related to the study treatment occurred. CONCLUSION: The use of hyaluronic acid based autologous fibroblast grafts was found to be a safe and effective treatment for diabetic foot ulcers.
Diabetic Foot ; Fibroblasts ; Humans ; Hyaluronic Acid ; Transplants ; Ulcer ; Vital Signs ; Wound Healing

PURPOSE: Platelet transplantation is a novel therapeutic strategy for acceleration of wound healing. When applying platelets, efficacy of adding thrombin to stimulate growth factor release from platelets has already been proven. However, no quantitative data of the thrombin treatment has been reported. The purpose of this study is to determine the optimal thrombin concentration to maximize growth factor release of platelets. In particular, this study was designed to quantify levels of platelet derived growth factor(PDGF)-BB, which is a major growth factor containing in the platelets, in vitro. METHODS: Fresh platelets were obtained from a blood bank. They were suspended in DMEM/F-12 and incubated with thrombin of various concentrations. The concentrations of thrombin tested were 0, 6.25, 12.5, 25, 50, 100, 200, and 400IU/mL. After 30 minutes, 1, 3, 5, and 7 days, the levels of PDGF-BB were measured using enzyme linked immunosorbent assay. Platelets from four donors were included in this study. Each sample was tested in triplicate and the mean value was used as a data for each sample. RESULTS: The addition of thrombin increased the level of PDGF-BB. Increases in storage time of platelets resulted in decreased levels of PDGF-BB. Higher levels of PDGF were detected in consort with increased thrombin concentrations. However, there was no significant difference between samples of 200 and 400IU/mL concentrations. CONCLUSION: The results indicate that adding thrombin accelerates the release of growth factors from platelets and the optimal thrombin concentration to maximize this function is 200IU/mL.
Acceleration ; Blood Banks ; Blood Platelets ; Enzyme-Linked Immunosorbent Assay ; Humans ; Intercellular Signaling Peptides and Proteins ; Proto-Oncogene Proteins c-sis ; Thrombin ; Tissue Donors ; Transplants ; Wound Healing

Papillary carcinomas account for 85~90% of all thyroid cancers, with the tumor size considered an important prognostic factor. As the use of high-resolution ultrasonography and fine needle aspiration biopsy have increased, the diagnosis of papillary microcarcinomas of the thyroid gland; defined by the World Health Organization as being less than 1 cm in diameter, has increased. They are generally associated with an excellent prognosis, with distant metastasis being extremely rare. They usually remain clinically silent until their incidental histological diagnosis by autopsy or surgical material. The incidence discovered at autopsy varies between 3 and 36%. Cervical lymph node metastases from papillary microcarcinomas have often been discovered, which may be the first and sole manifestation of the disease, without clinical suspicion of a thyroid tumor. Herein, the case of a papillary thyroid microcarcinoma, diagnosed after a total thyroidectomy due to its first presentation as a contralateral cervical lymph node metastasis, without evidence of a clinical thyroid tumor, is described.
Autopsy ; Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Incidence ; Lymph Nodes* ; Neoplasm Metastasis* ; Prognosis ; Thyroid Gland* ; Thyroidectomy ; Ultrasonography ; World Health Organization

OBJECTIVE: Assisted reproductive technology has been associated with an increase in multiple pregnancies. The most effective strategy for reducing multiple pregnancies is single embryo transfer. Beginning in October 2015, the National Supporting Program for Infertility in South Korea has limited the number of embryos that can be transferred per in vitro fertilization (IVF) cycle depending on the patient's age. However, little is known regarding the effect of age and number of transferred embryos on the clinical outcomes of Korean patients. Thus, this study was performed to evaluate the effect of the number of transferred blastocysts on clinical outcomes. METHODS: This study was carried out in the Fertility Center of CHA Gangnam Medical Center from January 2013 to December 2014. The clinical outcomes of 514 women who underwent the transfer of one or two blastocysts on day 5 after IVF and of 721 women who underwent the transfer of one or two vitrified-warmed blastocysts were analyzed retrospectively. RESULTS: For both fresh and vitrified-warmed cycles, the clinical pregnancy rate and live birth or ongoing pregnancy rate were not significantly different between patients who underwent elective single blastocyst transfer (eSBT) and patients who underwent double blastocyst transfer (DBT), regardless of age. However, the multiple pregnancy rate was significantly lower in the eSBT group than in the DBT group. CONCLUSION: The clinical outcomes of eSBT and DBT were equivalent, but eSBT had a lower risk of multiple pregnancy and is, therefore, the best option.
Blastocyst* ; Embryo Transfer* ; Embryonic Structures ; Female ; Fertility ; Fertilization in Vitro ; Humans ; Infertility ; Korea ; Live Birth ; Pregnancy ; Pregnancy Rate ; Pregnancy, Multiple ; Reproductive Techniques, Assisted ; Retrospective Studies ; Single Embryo Transfer

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Infectious mononucleosis is an EBV-induced infection, and this is a self-limiting clinical syndrome with such characteristics as fever, pharyngitis, headache, splenomegaly, hepatomegaly and multiple lymphadenopathy among children and young adults. On the other hand, EBV infection-induced gastrointestinal symptoms like anorexia, nausea, vomiting, dyspepsia, abdominal pain, gastric bleeding and diarrhea are non-specific signs and there is less of a chance of EBV infection being involved with gastrointestinal disease. Especially, the relation of gastric cancer and gastric lymphoma with EBV infection is well defined, but other EBV-related gastrointestinal diseases have rarely been reported. Therefore, we report here on a case of acute erosive EBV gastritis that was diagnosed as EBV-induced infectious mononucleosis, and this was confirmed by esophagogastroduodenoscopy with biopsy.
Abdominal Pain ; Anorexia ; Biopsy ; Child ; Diarrhea ; Dyspepsia ; Endoscopy, Digestive System ; Epstein-Barr Virus Infections ; Fever ; Gastritis* ; Gastrointestinal Diseases ; Hand ; Headache ; Hemorrhage ; Hepatomegaly ; Herpesvirus 4, Human* ; Humans ; Infectious Mononucleosis* ; Lymphatic Diseases ; Lymphoma ; Nausea ; Pharyngitis ; Splenomegaly ; Stomach Neoplasms ; Vomiting ; Young Adult

Gastric mucosal calcinosis (GMC) is a very rare condition that is characterized by the nodular deposition of calcium salts in the gastric mucosa. It has been associated with renal failure, gastric cancer, ingestion of aluminum- containing antacids and the use of sucralfate in organ transplant patients. The etiology of this condition is uncertain, but several theories have been proposed; the condition is due secondarily to hyperparathyroidism in renal failure and to the alkalinization of the gastric mucosa. We report here on two patients who had long-term use of bismuth and/or aluminum-containing antacids to treat their gastro-esophageal reflux symptoms. The esophagogastroduodenoscopy revealed acute gastritis patterns, and GMC was confirmed histologically with biopsy. When one patient stopped ingesting bismuth-containing antacid solution, the follow-up esophagogastroduodenoscopy and the biopsy revealed a completely improved state. We report here on these interesting cases and we include a brief review of the literature.
Antacids ; Biopsy ; Bismuth ; Calcinosis* ; Calcium ; Eating ; Endoscopy, Digestive System ; Follow-Up Studies ; Gastric Mucosa ; Gastritis ; Gastroesophageal Reflux ; Humans ; Hyperparathyroidism ; Renal Insufficiency ; Salts ; Stomach Neoplasms ; Sucralfate ; Transplants

Inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2) have been known to be involved in various pathophysiological processes such as inflammation. This study was performed to determine the regulatory function of superoxide dismutase (SOD) on the LPS-induced expression of iNOS, and COX-2 in RAW 264.7 cells. When a cell-permeable SOD, Tat-SOD, was added to the culture medium of RAW 264.7 cells, it rapidly entered the cells in a dose-dependent manner. Treatment of RAW 264.7 cells with Tat-SOD led to decrease in LPS-induced ROS generation. Pretreatment with Tat-SOD significantly inhibited LPS-induced expression of iNOS and NO production but had no effect on the expression of COX-2 and PGE2 production in RAW 264.7 cells. Tat-SOD inhibited LPS-induced NF-kappaB DNA binding activity, IkappaBalpha degradation and activation of MAP kinases. These data suggest that SOD differentially regulate expression of iNOS and COX-2 in LPS-stimulated RAW 264.7 cells.
Animals ; Cell Line ; Cyclooxygenase 2/*genetics/metabolism ; Cytokines/immunology ; *Gene Expression Regulation ; Lipopolysaccharides/immunology/metabolism ; Mice ; Mitogen-Activated Protein Kinase Kinases/metabolism ; NF-kappa B/metabolism ; Nitric Oxide/metabolism ; Nitric Oxide Synthase Type II/*genetics/metabolism ; Reactive Oxygen Species/metabolism ; Superoxide Dismutase/*metabolism

Pregnancy related stroke is rare and poorly understood. A 28-year-old pregnant woman at 20 weeks of gestation presented with sudden headache and left homonymous hemianopsia. MRI revealed acute right posterior cerebral artery territory infarction. Laboratory data revealed combined protein C and S deficiencies. Coagulation profiles returned to normal 6 months after the delivery. Although stroke can occur either with protein C or S deficiency, acute cerebral infarction associated with combined protein C and S deficiencies during gestation is very rare.
Adult ; Cerebral Infarction ; Female ; Headache ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Pregnancy* ; Pregnant Women ; Protein C* ; Protein S ; Stroke*

Essential fatty acid (EFA) is known to be required for the body to function normally and healthily. However, the effect of EFA on glucose uptake in skeletal muscle has not yet been fully investigated. In this study, we examined the effect of two EFAs, linoleic acid (LA) and alpha-linolenic acid (ALA), on glucose uptake of C2C12 skeletal muscle cells and investigated the mechanism underlying the stimulatory effect of polyunsaturated EFAs in comparison with monounsaturated oleic acid (OA). In palmitic acid (PA)-induced insulin resistant cells, the co-treatment of EFAs and OA with PA almost restored the PA-induced decrease in the basal and insulin-stimulated 2-NBDG (fluorescent D-glucose analogue) uptake, respectively. Two EFAs and OA significantly protected PA-induced suppression of insulin signaling, respectively, which was confirmed by the increased levels of Akt phosphorylation and serine/threonine kinases (PKCtheta and JNK) dephosphorylation in the western blot analysis. In PA-untreated, control cells, the treatment of 500 microM EFA significantly stimulated 2-NBDG uptake, whereas OA did not. Phosphorylation of AMP-activated protein kinase (AMPK) and one of its downstream molecules, acetyl-CoA carboxylase (ACC) was markedly induced by EFA, but not OA. In addition, EFA-stimulated 2-NBDG uptake was significantly inhibited by the pre-treatment of a specific AMPK inhibitor, adenine 9-beta-D-arabinofuranoside (araA). These data suggest that the restoration of suppressed insulin signaling at PA-induced insulin resistant condition and AMPK activation are involved at least in the stimulatory effect of EFA on glucose uptake in C2C12 skeletal muscle cells.
Acetyl-CoA Carboxylase ; Adenine ; alpha-Linolenic Acid ; AMP-Activated Protein Kinases* ; Blotting, Western ; Fatty Acids, Essential* ; Glucose* ; Insulin ; Linoleic Acid ; Muscle, Skeletal* ; Oleic Acid ; Palmitic Acid ; Phosphorylation ; Phosphotransferases